Solitary mediastinal angiomatosis: report of two cases and review of the literature.

Angiomatosis is a rare benign vascular lesion, usually seen in females in the first two decades of life. It commonly involves the lower extremities. Angiomatosis of mediastinum is very rare and we report two such cases with a review of the literature on solitary mediastinal angiomatosis. Both of our patients were female, aged 34 and 57 years. One patient presented with left-sided subcutaneous supraclavicular swelling. Magnetic resonance imaging showed a mass extending from the left upper mediastinum to the left supraclavicular area. The other patient presented with pleural effusion. Computed tomography of the chest disclosed an infiltrative mass in the mediastinum. Both patients were treated by excision of the lesions, histologically confirmed to be angiomatosis. Despite the rarity of mediastinal angiomatosis, this clinicopathological entity must be taken into consideration when the treatment of mediastinal tumours is planned.

Diagnosis and management of acute and early complications of/after bariatric surgery.

The number of obese people is over one billion worldwide, and the trend is increasing. Frequent failure of conservative approach has been observed. Therefore, various surgical techniques, such as bariatric surgery, are accepted today as a safe and effective treatment of morbid obese condition, and are associated with low perioperative morbidity and mortality rates. The most popular and commonly performed procedures are those related to minimum complications and adequate weight loss: laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass. Since major and minor complications occur in the perioperative, early and late postoperative period, we discuss most frequent complications and importance of early recognition as well as adequate interventions.

Laparoscopic cholecystectomy in an ambulatory setting--initial experience in Croatia.

BACKGROUND/AIMS: The purpose of this study was to discover if ambulatory laparoscopic cholecystectomy is feasible in our environment and to determine the factors which will predict its success. METHODOLOGY: From November 12th 2002, to February 25th 2005 one hundred and fifty patients were admitted to our surgical ward of the General Hospital in Bjelovar due to cholelithiasis or biliary colic. Patients were unselected. Six to eight hours after the surgery we rated the ability of the patients to be discharged from the hospital (although they weren't discharged). RESULTS: The research has shown that 61% of the patients were eligible for ambulatory procedure. Among ultrasonographic attributes the most significant independent predictive factor of potential complications, prolongation of the procedure and ineligibility of the patient for the ambulatory laparoscopic cholecystectomy in our study was the thickened wall of the gallbladder. Among non-ultrasound preoperative attributes, the most important are the anamnestic data of prior cholecystitis and ASA classification. Pain was the most common reason why the patients were classified as non-candidates (36.6%). In the second place (25.4%) was the negative subjective patient's judgement to be discharged when all objective parameters were good. CONCLUSIONS: LC is also feasible in our environment but the patient's own motivation is the key factor in our situation.